Acute pancreatitis occurs when the pancreas becomes inflamed over a short period. This inflammation is most commonly triggered by gallstones and alcohol consumption, but several other causes and contributing factors exist.
Alcohol Use
Heavy or prolonged alcohol use is one of the leading causes of acute pancreatitis globally—and especially in South Africa. Alcohol can irritate the pancreas and lead to premature activation of digestive enzymes, causing tissue damage.
A South African study published in the South African Journal of Surgery found that 62% of acute pancreatitis cases at a regional hospital were linked to alcohol use. This reflects the significant role alcohol plays in local cases compared to some international trends.
Gallstones
Gallstones are another major cause, particularly in women and older adults. These stones can block the bile duct, trapping pancreatic enzymes and causing inflammation. Gallstones are also a leading cause of acute pancreatitis globally.
In the same South African study, 14% of cases were attributed to gallstones, with an additional 4% caused by both gallstones and alcohol.
Other Known Causes
Acute pancreatitis can also result from other conditions and factors, including:
- High triglyceride levels (dyslipidaemia)
- Certain infections, including mumps and HIV
- Medications (e.g., antibiotics, diuretics, chemotherapy)
- Abdominal trauma or post-surgical complications
- Genetic conditions
The study also highlighted that 8% of cases were linked to dyslipidaemia and 5% to retroviral disease (such as HIV), emphasizing the role of these additional causes in South Africa.
Idiopathic Pancreatitis
In some cases, no clear cause can be found. These are known as idiopathic cases, and further testing is often required to uncover underlying issues. Potential causes include genetic mutations, autoimmune disease, or even microscopic gallstones that are too small to detect with routine imaging.
Interestingly, 15% of cases in the regional hospital study were deemed idiopathic, where no clear cause could be identified despite thorough investigation.
Local Insight and Study Findings
A South African study from June 2001 to April 2006 examined 322 admissions of 282 patients with acute pancreatitis at a regional hospital. The findings reinforced alcohol as the leading cause of the condition, consistent with international reports, but also pointed to specific local factors.
Outcomes: Of the 322 cases, 9% ended in death, with most of the deaths occurring in the first two weeks of hospitalisation. This early mortality rate suggests that improved supportive care could help improve overall survival.
Source:
South African Journal of Surgery, Vol. 46 (3), 2008, pp. 83-86.
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Reviewed April 2025. Always consult a professional for individual guidance.
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